EEG can be conveniently performed in remote rural areas and transmitted by telephone-modem.It is used a lot in areas like the Appalachians. However the quality of these transmissions as a rule is poor and these EEGs are more or less symbolic in nature while contributing little to patient management. Ideally the EEG should be done under the direct and immediate supervision of a neurologist after a focussed history taking by the neurologist so that the diagnostic yield is maximized. We do not use tele-EEG at all since we believe that poor quality of the recordings makes it more of a symbolic test than something that is useful. If it is worth doing an EEG it is worth doing it under ideal conditions ,ie in a quiet room with no electrical interference , using computerized digital equipment , and it is well worth being done under the supervision of a neurologist since it is basically an electronic extension of the neurological examination.